Building a Successful Practice of Endoscopic Spine Surgery: Learning, Setting the Goal, and Expanding the Border

Commentary on “Complications and Management of Endoscopic Spinal Surgery”

“…The development of spinal endoscopic surgery is rapidly developing along with these demands, but related complications are also increasing due to the lack of educational courses and difficulties in training in spinal endoscopic surgery. [1][2][3] In the March issue of Neurospine, the special issue of endoscopic spinal surgery was conducted with the theme of "The road to expansion and standardization of Endoscopic Spine Surgery", in particular, "Complications and Management of Endoscopic Spinal Surgery" reported by Ju et al 4 can be said to be a very important and interesting study in terms of anticipating the expansion of spinal endoscopic surgery, and I was able to enjoy the authors' reports and arguments with interest.According to reports by Ju and Lee, 4 endoscopic spinal surgery can also cause complications in all parts similar to open surgery, but, in cervical area, it is reported that serious complications occur less in the posterior compared to the anterior approach, and, compared to the uniportal approach, reports of complications related to the biportal approach are lacking.In addition, the occurrence of overall complications occurs in less than 10%, and it is said that the incidence of life-threatening complications is less than that of open surgery. This is to say that the operation can be performed more safely compared to the existing open surgery, but, on the contrary, it also means that better treatment results can be derived through sufficient reports on complications related to endoscopic spinal surgery.However, as the author said, some complications can be major complications that can lead to life-threatening complications such as lower extremity paralysis, so care must be taken in the decision and technique of endoscopic spinal surgery.…”

“…The development of spinal endoscopic surgery is rapidly developing along with these demands, but related complications are also increasing due to the lack of educational courses and difficulties in training in spinal endoscopic surgery. [1][2][3] In the March issue of Neurospine, the special issue of endoscopic spinal surgery was conducted with the theme of "The road to expansion and standardization of Endoscopic Spine Surgery", in particular, "Complications and Management of Endoscopic Spinal Surgery" reported by Ju et al 4 can be said to be a very important and interesting study in terms of anticipating the expansion of spinal endoscopic surgery, and I was able to enjoy the authors' reports and arguments with interest.…”

Commentary on “The Role and Clinical Outcomes of Endoscopic Spine Surgery of Treating Spinal Metastases; Outcomes of 29 Cases From 8 Countries”

“…Minimally invasive surgery has shown promising outcomes, minimizing the damage to soft tissue and resulting in less blood loss. [7][8][9] However, it is important to note that not all treatment methods are suitable for every patient, and each approach has its own advantages and limitations. 4 A recent procedure, called endoscopic spine surgery, has emerged as a potential alternative.…”

“…It minimizes collateral damage, blood loss, and duration of hospital stay, while being as effective as open suegery in alleviating pain and restoring neurological function. 7,8,10,11 Despite being supported primarily by case reports or case series, endoscopic spine surgery remains underutilized in patients with spinal metastases. This study 12 represents the first investigation using a worldwide collaborative network of endoscopic spine surgeons, known as 'ESSSORG, ' comprising 12 centers across 8 countries (South Korea, Thailand, Taiwan, Mexico, Brazil, Argentina, Chile, and India).…”

“…Open surgical procedures for spinal metastases carry a higher risk of complications, making minimally invasive procedures preferable as they can relieve neural systems without compromising spinal stability. Minimally invasive surgery has shown promising outcomes, minimizing the damage to soft tissue and resulting in less blood loss [ 7 - 9 ]. However, it is important to note that not all treatment methods are suitable for every patient, and each approach has its own advantages and limitations [ 4 ].…”